Factors Associated with Mother-infant Interaction on the Drakenstein Child Health Study

Abstract The quality of mother-child interactions can affect child developmental outcomes, both positively and negatively. Little research has examined the factors that influence the quality of mother-infant interactions, particularly in a low-middle income country. Therefore, we examined sociodemographic, maternal, and child variables, to determine whether these were associated with the quality of maternal-infant interactions. 256 mother-infant dyads enrolled in a South African birth cohort study, the Drakenstein Child Health Study, were assessed. A comprehensive battery of sociodemographic and psychosocial questionnaires was utilised. Video footage of interaction between mothers and infants at a 14-week postnatal visit was coded and assessed using the Global Rating Scale (GRS). Hierarchical multiple linear regression models were used to examine the factors associated with the GRS domains. The domains included: (1) maternal sensitivities (sensitivity, intrusiveness, remoteness, depressive mood), (2) infant behaviours (sensitivity, inertness, distress), and (3) maternal-infant interaction. Maternal childhood trauma and smoking during pregnancy were associated with lower domain scores for the maternal contribution. Higher birth weight and initiated breastfeeding were associated with higher domain scores for infant behaviours, while maternal IPV exposure, and smoking tobacco were associated with lower domain scores for infant behaviours. Infant weight-for-age at birth and initiated breastfeeding were positively associated with the dyadic interaction. Factors associated with early positive and negative mother-infant interaction identified in this research could potentially serve as targets for intervention, with the ultimate aim of improving child developmental outcomes. Notably, no psychosocial variables were significantly associated with the dyadic interactions, emphasising how strong such interactions can be in the face of multiple stressors.